Hospital workers fear layoffs under Tenet Healthcare.

Tenet Healthcare Corp.'s plan to acquire Queen of Angels-Hollywood Presbyterian Medical Center has sent ripples of concern through the medical center's staff as well as community and consumer health care advocates who fear layoffs, a drop in the quality of care and less care for the indigent.

"The employees are definitely worried for their jobs," said Monem Fadali, president of the medical staff. "The speculation here is that the administrative and management people at the higher levels will get the brunt of the layoffs."

Last month, 28 full-time employees were laid off at the hospital, which has a total full-time staff of 1,000.

"When it makes these acquisitions, Tenet does tend to consolidate the management and back-office operations," said Randall Huyser, a research analyst with the investment firm Furman Selz LLC.

Critics of the proposed acquisition cite other Tenet purchases in which layoffs have occurred, including at the Encino-Tarzana Medical Center and Harbor View Medical Center in San Diego.

Tenet officials stress that each hospital is a different situation and note that they have actually hired nursing staff at Brookside Hospital in the East Bay area near San Francisco.

On Aug. 14, Queen of Angels-Hollywood Presbyterian and Santa Barbara-based Tenet signed a letter of intent. A final deal is expected to be signed within 60 days, after which time it must be reviewed by the state Attorney General's Office. That review is expected to take until the end of the first quarter of 1998 and will include at least one public hearing.

Queen of Angels-Hollywood Presbyterian officials said a sale is the only way to ensure that the hospital remains viable over the long term.

"We are one of the few stand-alone hospitals remaining in Southern California," said spokesman Bob Steward. "With the demands of managed care and the trend toward managed care contracts, the financial viability of the hospital makes it essential to combine with a larger organization."

Those opposing the sale include the union representing most of the hospital staff, Consumers Union and several community-based organizations.

In the last two months, a coalition of two dozen of these groups has emerged, calling itself the Los Angeles County Coalition for Quality Health Care.

Coalition founder Lark Galloway Gilliam said the group's goal is to ensure that Tenet maintains the same commitment to community care that Queen of Angeles has displayed in the past.

"We are very concerned that we might lose indigent care. After all, it is not a moneymaker, and that's what Tenet is out to do, make money," Gilliam said.

Julio Mateo, a staff attorney with Consumers Union in San Francisco, said he is concerned about the lack of community input in the acquisition negotiations.

"These are community assets we're talking about here and this deal is being worked out behind closed doors," he said.

Tenet spokesman Lance Inyon said the letter of intent includes provisions to set up a charity foundation to care for the poor and uninsured in the surrounding community.

Meanwhile, hospital medical staff chief Fadali said physicians fear the hospital's quality of care will decline under Tenet, especially if there are any cuts in the nurse-to-bed ratio.

Inyon said it is "premature" for anyone to determine the nurse-to-bed ratio before due diligence is completed.